1. The Edward Jenner Programme Challenges in Healthcare

2. Changes in Demographic and Disease Profiles
There are many new challenges in healthcare, including changes in the kinds of illnesses to be confronted. For example, the major post-war curable diseases, such as measles and diphtheria are largely conquered. Instead chronic and multiple diseases associated with an ageing population, and lifestyle choices (such as obesity and smoking), are becoming more important.
What changes have you noticed in your area due to this challenge?
Has this had an impact on the types of tasks/activities you are doing?
Note you responses on the online portal.

3. Changes in Patterns of Illness and Pressure on Budgets
Due to the changing pattern of illness and longer-term pressures on budgets healthcare goals are changing. Alongside traditional ‘treatment’ goals, ‘predict and prevent’ goals have become much more important. ‘Health promotion’ and ‘working with partner organisations’ now plays a vital role, and care in the community is increasingly important as public health moves back to the centre of health policy.
In what ways are budgetary pressures making your team think differently about its overall goals?
Are you now involved more in ‘predict and prevent’ activities? What partnerships are you now working in which didn’t exist recently?
Note you responses on the online portal.

4. Greater Expectation from Patients and Community
The expectations of patients, carers and communities are for ever increasing, with more widespread knowledge about health available via the internet, less deference towards professional and medical authority, and higher expectations of personalised and flexible care.
How have changes in patient expectations affected the work of your team and indeed your own role?
What’s the most challenging situation you’ve faced due to patient/community expectations?
Note you responses on the online portal.

5. New Techniques and Technologies
New techniques and technologies are developed in health all the time and they require new ways of working both within and across teams, and with patients.
Which technology has made the biggest impact on improving your work or that of your team?
Which technology do you think has made the biggest difference to patients in your area?
This could for example be due to making your service easier to access, or it could be improved support services.
Note you responses on the online portal.

6. New Approaches to Self-Sustaining Continuous Improvement
With change and improvement happening as a matter of course, we need to ensure that healthcare keeps getting better. This relies as much on mobilising and motivating staff as on the changing techniques themselves.
How empowered do you feel to be able to make changes in your area which would improve the service you provide? What impacts on your level of empowerment?
How often does your team make suggestions to improve things? Could it be done more often? What gets in the way of people offering suggestions?
Note you responses on the online portal.

7. The Increasing Emphasis on Step-Change Innovation
The focus isn’t just on continuous improvement. Many healthcare professionals and organisations are also aiming to improve and develop safety, quality and efficiency in healthcare in radical ways.
What is the most significant innovation that has changed how you do your job over your career?
What is the one thing would make the biggest difference to you or your team if it could change in a radical way tomorrow?
Note you responses on the online portal.

8. The Organisations of Healthcare are Changing
It’s not only the organisations themselves, such as Clinical Commissioning Groups and merged Trusts, which are changing and developing. New cultures and ways of working are also emerging in line with changing healthcare needs.
What different forms have the organisations you’ve worked in during your career taken, how have they changed?
What feels different about working where you are today compared to 2, 5, 10 years ago?
So as you can see there are a lot of challenges facing the healthcare industry and the NHS in particular. The exercise we’ve just been through should have helped you develop an understanding of how these challenges and changes are important for you and your teams.
Note you responses on the online portal.

9. Financial Challenges

10. Financial Challenges
How do the financial resources in the current financial year (April to April) for your area, compare to last year?
See if you can find out what is likely to happen next year. You may already have this information to hand, but your team leader or manager should be able to help you if not.
Is the overall trend one of increasing funding, decreasing funding or roughly stable funding?
Note you responses on the online portal.

11. How is your Capacity?
Let’s look at what is happening to the volume of work over the same period.
If you work in a clinical service, the indicator here is probably simply the number of patients you are seeing.
If you work in a non-clinical service, the indicators of work volume will depend very much on what it is you and your team do – serve meals, maintain buildings, provide accountancy support or move people and equipment around a hospital, for example.
You will probably need to talk to whoever is leading or in charge of your team to clarify what is a meaningful measure of workload for the team as a whole, and how it is changing.
Note you responses on the online portal.

12. Tension and Opportunity
What tensions or opportunities does the funding available and volume of work present for you?
You may at this point want to consider further the relevance of the four choices set out in the NHS Confederation Briefing you have read.
Which one do you think is actually being pursued by those in charge of your service?
Do you think that a different one should in fact be pursued?
Note you responses on the online portal.

13. Re-Designing Care

14. Team Challenge
Imagine that you are part of a team within a hospital trust. In groups of 4-6 spend 15 minutes investigating this challenge from the perspectives of the different stakeholders involved; for example the patients, the clinicians, the managers in your organisation, and the financial controllers.
Use the hand out to help structure your thoughts and once complete, note down your responses on the online portal.